Authors say clinicians should evaluate trade-offs between pharmaceutical and surgical management of obesity
By Lori Solomon HealthDay Reporter
TUESDAY, Oct. 29, 2024 (HealthDay News) — Among privately insured patients, there was a doubling in the use of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) as antiobesity treatment from 2022 to 2023, with a simultaneous 25.6 percent decrease in the rate of metabolic bariatric surgery, according to a research letter published online Oct. 25 in JAMA Network Open.
Kevin Lin, from Harvard Medical School in Boston, and colleagues assessed national trends and characteristics of patients with obesity who were prescribed GLP-1 RAs versus those undergoing metabolic bariatric surgery. The analysis deidentified claims data from 17 million unique adult patients with obesity and without diabetes with medical and pharmaceutical coverage through commercial and Medicare Advantage insurance.
The researchers identified 81,092 patients who were prescribed GLP-1 RAs (9.6 percent aged 18 to 35 years) and 5,173 patients who underwent metabolic bariatric surgery (17.5 percent aged 18 to 35 years). Greater medical complexity was seen in patients undergoing metabolic bariatric surgery versus those prescribed GLP-1 RAs or no treatment (18.8 versus 8.2 percent versus 11.1 percent with four or more comorbidities). There was a 132.6 percent increase in patients prescribed GLP-1 RAs between the last six months of 2022 and the last six months of 2023 (1.89 versus 4.41 patients per 1,000 patients). Simultaneously, there was a 25.6 percent decrease in patients undergoing metabolic bariatric surgery (0.22 versus 0.16 patients per 1,000 patients).
“Policymakers and clinicians should continue to closely monitor trade-offs between pharmacologic and surgical management of obesity to ensure optimal access to effective obesity treatment,” the authors write.
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